A group of 32 physician trainees from the Texas Medical Center’s leading hospitals gathered at Rice’s Jones Graduate School of Business in April for an intensive 14-day new certificate program designed to impart essential management skills critical to a successful career in medicine and health care.

Louis Gilbert, a family medicine resident at Baylor College of Medicine, participated in the Rice Education in Management for Physician Trainees program. Photos by Jeff Fitlow

Led by distinguished Jones School faculty, the Rice Education in Management for Physician Trainees program (REMP) grew out of a recommendation from faculty and practitioners at academic medical centers, including Baylor College of Medicine, The University of Texas MD Anderson Cancer Center, Houston Methodist Hospital and The University of Texas McGovern Medical School. Those sources said that apart from clinical training, physicians need to learn interpersonal, communication and leadership skills, effective teamwork, professionalism and systems-based management practice so they are better prepared to address the business challenges of the health care profession today. This is a view echoed by the Association of American Medical Colleges, the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education, according to program organizers.

The program comes at a time when health care, the largest industry in the U.S., faces many challenges, including skyrocketing costs, increasing demand, inadequate access to care, inefficiency, inconsistent quality of services and nonuniform processes, program organizers said. With growing recognition that many of these challenges are truly business problems, the industry is slowly realizing the need to change the way physicians get trained, which the organizers said has not changed substantially since 1910, and how they work.

The idea for the program originated in spring 2015, said Dr. Binata Mukherjee, director of the Jones School’s Health Care Initiative, which coordinates the program. “We were exploring how else we can service the physician community and the health care professionals across the medical center,” she said.

“We realized that the medical and health care landscape has been changing,” Mukherjee said. “The industry is in flux. Physicians need management education, but it is nowhere in their curriculum, (either) in medical school or residency or afterward. They do not have a formal management education, but they are expected to take leadership positions. Even at the point of care delivery, the physician is a leader, whether performing a tracheostomy or putting a tube in the esophagus. What we are doing is trying to get all the management skills taught in a comprehensive and structured manner for a large group of people.”

Modules included Working in Teams: Leading and Collaborating While Delivering Care, taught by Brent Smith, associate professor of management, associate professor of psychology and senior associate dean of executive education; Negotiation and Influence Strategies, taught by Jing Zhou, the Houston Endowment Professor of Organizational Behavior; and Analyzing Cost in Hospitals, taught by Shiva Sivaramakrishnan, the Henry Gardiner Symonds Professor in Accounting.

“The cost aspect of health care … is a big thing these days,” Sivaramakrishnan said. “My area is management accounting. There are some new paradigms coming out in this area. Things like ‘How do you measure cost at the patient level? How do you deliver value to the patient? How do you make sure that you do not compromise health outcomes because of cost consideration?’ So it’s a very complicated thing that physicians and health care providers face. Rice is so uniquely positioned next to (these) establishments … and I’m so happy to contribute.”

Sivaramakrishnan said teaching “very intelligent” physician trainees allows him to tailor the course content so it is thoroughly relevant. “Going through medical education is very demanding,” he said. “Although I cannot assume a content knowledge … I want to teach the course in a way that will make them understand how their actions are going to influence costs. Health care is so complex. When you talk about value and what you deliver to your patients, you cannot sacrifice anything. We are talking about people’s health. At the same time, if we can sensitize them to the cost aspect … can they navigate the system in a way that they don’t sacrifice the outcome?”

For some of the participants, who applied and were selected at the institution level, the program was eye-opening.

“In medical school and residency, we get very little exposure to the business side of things, and with the field of medicine rapidly changing, I think it’s important now more than ever to really understand the business side of medicine,” said Dalia Moghazy, a third-year OB/Gyn resident at Houston Methodist Hospital. “I think it’s important to be able to apply business management principles to clinical management. I like that it’s (the program) very interactive and there’s a wide diversity of topics we learn about.”

Siddarth Thakur, a fellow in pain management at MD Anderson, said he appreciated the program’s collegial culture. “The thing I liked best about the course was meeting all my other colleagues who are in similar situations. They’re all fellows at various different institutions in the medical center. To be able to have discourse with them and discussions about what we learned in class was probably the most valuable. For other participants that are considering the course, I would emphasize that they really should do it, because we don’t have this sort of opportunity anywhere else.”

Physician leaders need ‘to be in the middle of the mix’

Thirty-two physician trainees from the Texas Medical Center’s leading hospitals participated in the inaugural program.

For the program’s sponsors in the medical center, the need for REMP is imperative.

“REMP is a unique program that I’m not sure exists anywhere else in the country,” said Dr. Jennifer Christner, dean of Baylor College of Medicine’s School of Medicine. “There is a strong need for this program, and we are fortunate that our residents are able to take part in this opportunity. I don’t know of another institution that has addressed this need so comprehensively.”

Dr. Robert Phillips, executive vice president and chief medical officer at Houston Methodist and a professor of cardiology at the Houston Methodist Institute for Academic Medicine, echoed Christner’s comments.

“A fundamental change in health care is underway that is driven by the understanding that best outcomes will be achieved through application of evidence-based medicine that is delivered in a coordinated, team-based and patient-centric fashion,” Phillips said. “Emerging clinical leaders will be most valuable when they are equipped with the tools that enable them to understand how their behaviors and performance link to the success of the larger health care system. We need physician leaders to be in the middle of the mix so that the ever-evolving changes in health care are informed by clinical expertise. To effect this change and goals, physicians need to be educated in the fundamentals of leadership; strategic thinking; organization behavior and design; finance; operations; and change management. The REMP program has been designed to enable emerging physician leaders to obtain these skills.”

The Health Care Initiative at the Jones School aims to provide relevant business education to young physicians who can jump-start their careers with skill sets that will not only set them apart but also respond to the critical need for “bending the cost curve” while improving health care outcomes. For more information, visit https://business.rice.edu/health-care-rice-university.